Method of splinting teeth



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METHOD OF SPLINTING TEETH Filed Aug. G, 1963 2 Sheets-Sheet 2 D WW Il United States Patent() 3,348,311 METHOD F SPLINTING TEETH Bernard Weissman, 3406 Poplar St., Oceanside, N.Y. 11572 Filed Aug. 6, 1963, Ser. No. 300,199 4 Claims. (Cl. 32-6) This invention relates to a splint for the reinforcement and retention of teeth in the mouth and to a method for the fabrication of the same.

The practice of reinforcing natural teeth by means of a splint structure disposed along the lingual surfaces of anterior teeth is now recognized in the practice of dentistry. The methods for the formation of such splints and their application are however accompanied by serious limitations'. Among the limitations in the current practice of the fabrication and application of splint structures is the requirement that securing pins for the splint structure formed integrally therewith must be disposed in horizontal parallelism. This requirement arises from the fact that the splint must be inserted from the lingual side and the fact that the securing pins which are intended to be inserted through perforations formed in the'tooth body are formed integrally with the splint structure. As a consequence of this, it has been found to be impractical, if not impossible, to apply such splints to other than the anterior teeth. The requirement of horizontal parallelism in the'securing pinY portion of the splint has also made it necessary to utilize involved and'complicated procedures in the preparation of the teeth and particularly in connection with the formation ofthe perfora'tions which are adapted to receive the securing pins. As a consequence of. this, special equipment has been developed and must be utilized in order to assure the requisite parallelism and the procedure from the point of view of theV dentist has been involved and time consuming. The procedures in-v volved are'also the source of considerable discomfort'to. thepatient. Y l 'u It is therefore Van object of this inventionto provide a splint structure which may be readily'secured to the lingual surfaces of the teeth desired to be reinforced'and preparation and dis- Another object of thisinvention is to provide a splint4 struct-ure which is adapted to be secured in position in the month by means of removable screws so as. to eliminate the requirement of parallelism in the apertures formed in the teeth for receiving the screws or in the screws them'- selves. Temporary insertion is made possible for purposes of alignment of loose teeth or the like. The arrangement is such that the splint structure may extend over and include posterior as well as anterior teeth.

It is also an object of this invention to provide a splint structure and a method for the fabrication of the same whereby the splint structure rmay include support means for artificial teeth to be simultaneously inserted'and positioned in the mouth.

It is also an object of this invention to provide 'afsplint structure and a method for the fabrication of the same wherein a maximum amount of adjustment may be accomplished in lthe installation of the structurein the mouth with a minimumamount of discomfort to the patient.

Other and further objects, benefits and advantages of the instant invention will more clearly appear from the description contained in the specification and claims as well as from the appended drawings wherein:

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FIGURE 1 is a plan View of the lower jaw showing the dentition of the mandible;

FIGURE 2 is a front elevational or facial view of the dentition shown yin FIGURE llwhen viewed along line 2-2 of said ligure;

FIGURE 3 is a fragmentary cross-sectional View taken along line 3-3 of FIGURE 2 and showing the locating pins in position;

FIGURE 4` is a cross-sectional view of a tooth surrounded by an impression material and showing a locating pin in position as viewed from line 4-4 of FIG- URE 3;

FIGURE 5 is a cross-sectional view of the impression of a tooth such as shown in FIGURE 4 showing the cast investment model;

FIGURE 6 is a fragmentary view partly in cross-section showing the model cast from an impression such as taken in FIGURE 4` removed from the impression material;

one of the anterior teeth is missing and will be replacedl by a splint supported arti'cial tooth;

FIGURE 10 is a perspective view of a metal splint after the casting operation; Y FIGURE 10A is' a perspective view of a resultant'cast metal splint for the type of dentition shown in FIGURES 9A and 9B;

FIGURE 1l is an enlarged fragmentary view partly inl section taken along line 11-11 of FIGURE l0;

' FIGURE 1,2 is a View showing 'the installation of a cast metal splint in themouth;

FIGURE 13 is a cross-sectional view taken along line 13-13 of'FIGURE 12 on an enlarged scale;

FIGURE 14 isa cross-sectional view of the securing nut in enlarged scale; Y

lFIGURE 15 is a side elevational viewof a threaded pin or screw adapted to be received within the nut shown in FIGURE 14; and

FIGURE 16 is a View, partly in section of a modified form of retaining screw having a plastic or synthetic resin head.

' The instantinvention will be described in conjunction with mandibular dentition as shown in FIGURES 1 and 2 wherein it is desired to install a retaining splint to overlie lingual areas of the anterior' teeth 20 as well as the lirst bicuspids 22. It will be understood that this particular splint installation is selected for illustrative purposes only and that the instant invention may be applied` to a wide variety of tooth combinations. As will be seen from said figures, the initial step for the preparation of `support and retention. Having Iselected the appropriateI FIGURE 7 is a cross-sectional View of one of the teethv of the model of" FIGURE 6 showing a threaded pin and desired location for the aperture in each of the involved teeth, the apertures are formed by a suitable drill 26` provided with a countersink shank 28 as indicated in FIGURE l. The lines 30 through the anterior teeth 20 and bicuspids 22 indicate the direction of the aperture axis in each of the aforesaid teeth. It will be noted that in involving the bicuspids 22, the axis of the apertures may be formed in convergent relation. This condition would make it impossible to insert a horizontal pin splint of the prior art from the lingual side.

Having formed the apertures 24 as indicated in FIG- URES l and 2 including countersink portions, locating pins 32 are inserted through the apertures as shown in FIGURE 3 and extend beyond the facial and lingual surfaces of each of the teeth. With the locating pins 32 in position an impression is then taken of the involved area as shown in FIGURE 4 using a rubber-type impression material 34 and an apertured tray not shown. Upon withdrawal of the locating pins 32 the impression 34 may be removed from the involved area and the locating pins may then be restored to their proper position in the rubber impression 34.

The next step in the procedure is illustrated in FIG- URE 5. As shown in said figure, a cast model 36 is formed from the impression utilizing an investment casting material capable of withstanding the temperatures involved in the lost wax process. Upon hardening of the investment cast model, the locating pins 32 may be removed and the resultant cast model 36 removed. An enlarged fragment of the cast model 36 is illustrated in FIGURE 6 showing that said model is an accurate reproduction of the involved area and includes the apertures or holes 24a formed in the cast teeth 40 precisely duplicating their location and orientation as initially formed in the natural teeth.

The next step in the procedure involves the formation of a wax-up corresponding to the configuration of the desired splint overlying the lingual areas of the involved teeth. As shown in FIGURE 7, a threaded pin 38 is inserted through each of the apertures 24a and a nut 42 of the configuration Ashown in FIGURE 14 is drawn up thereon. Since the nut 42 will form a part of the ultimate metal splint to be installed in the mouth, it is formed of a suitable dental metal such as a gold alloy or the like. It will further be noted that the nut 42 in addition to being internally threaded as shown at 44 is provided with end surfaces 46 disposed at a diagonal angle with respect to the axis of the nut. In view of the disposition of the end surfaces 46 of the nut 42 in a diagonal or oblique plane with respect to the axis of the nut it is possible to draw the nut into position as shown in FIGURE 7 so that a maximum area of the end surface of the nut is in contact with the confronting lingual surface of the tooth model and ultimately with the natural tooth. When the nut has been drawn up against the lingual surface of the model tooth and rotated so as to provide maximum surface contact between the end surface of the nut and the lingual surface of the tooth the nut is iixed in position by means of the application of a glob of sticky wax 48 or the like so as to ix the nut in position on the cast model of the tooth. When this has been accomplished, for all the involved teeth, the wax-up 50 of the splint body may be accomplished as shown in FIGURE 8 by coating the lingual surfaces of the model casting with a suitable investment wax. Having formed the Wax-up of the entire splint as indicated in FIGURE 8, the next step in the procedure is to form a metal casting of the splint by the conventional lost wax process used in dentistry. This is accomplished by investing the cast model and its wax-up in a suitable investment casting material and casting out the waxed-up portion as shown in FIGURES and l1 in a suitable dental metal. As will be seen from said FIG- URES l() and ll, which illustrate a form of metal cast splint 52, said casting has incorporated therein the nuts 42 which are now precisely oriented in alignment with the natural tooth apertures. The splint S2 may now be installed in the mouth utilizing the screws 54 shown in FIGURE 15.

As may be seen from FIGURE l2, this installation is accomplished by locating the splint 52 against the lingual surfaces of the involved teeth 56 and inserting a screw 54 into each of the apertures in the tooth and threadedly engaging said screw with an associated nut 42 imbedded within the body of the splint in precise registration therewith. The screw is inserted until the screw head 58 is disposed within countersunk portion 60 of the tooth aperture as shown in FIGURE 13 and any excess metal of the screw head may be ground off as desired. It is preferred to form the depth of the countersink portion of the aperture so as to exceed the depth of the screw head 5S so that when completely seated within the countersink a space is available which may be filled with a material matching the tooth color if desired. It is also possible to form the screw with a head of a material matching the tooth color so that when in position it will match the tooth coloring and its location will not be discernible. A screw 62 ofthis type is shown in FIGURE I6 and may be formed by providing a threaded metal rod or pin 64 with a head 66 formed of a plastic material such as an epoxy or acrylic resin. The head 66 may be made large enough so as to permit being manually grasped and turned and is preferably stepped as shown at 63 to form a portion capable of entering the countersink. The distribution of pressure against the tooth surface by the enlarged area of the screw head prevents splitting of the tooth as the screw is drawn up and tightened. The screw head may then be cut and the portion remaining in the tooth countersink blends more easily with the tooth and irnproves adhesion of any covering material which may be employed. A minimum of metal, if any, is exposed along the facial surface of the tooth. Any excess of the screw stem extending beyond the lingual surface of the splint maybe cut and ground olf so as to provide a smooth continuum along the lingual surface of the splint. FIGURE 13 shows in cross-section the disposition of the splint in mounted relation to the tooth.

It will be noted from the foregoing that since the screws are inserted from the facial side of the teeth the requirement for parallelism in the tooth apertures is completely eliminated, and a simple procedure is provided for forming complimentary threaded portions in the splint in perfect alignment with the tooth apertures so as to permit the utilization of screw-threaded elements inserted from the facial side of the teeth. It will be further noted that in view of the non-critical character of the aperture locations in the teeth with respect to each other it is possible to select the most convenient and anatomically desirable location for the aperture in each screw and permits the formation of apertures in teeth where heretofore it has been impossible or impractical to do so. It will also be noted that the insertion of the screws from the facial side permits the overlapping of the splint to bicuspid teeth thus providing highly improved retention characteristics.

The instant method also permits for the production of splints which may be utilized for the support of artificial teeth used to replace missing teeth in the particular dental area involved. The method for the formation of a splint of this character is illustrated in FIGURE 9A, 9B and a resultant splint is illustrated in FIGURE 10A. Assuming a condition such as is illustrated in FIGURE 9B wherein one of the incisors 70 is missing as shown at 70a, the cast model 72 is waxed-up as illustrated at 76 in FIG- URE 9A incorporating a waxed area 74 which will form a support for the missing tooth 70a. When a waxed-up model of the character shown in FIGURE 9A is cast out, a resultant splint 78 illustrated in FIGURE 10A may then be installed in the mouth after proper processing to incorporate the missing tooth. The splint thus provides an ellicient and effective support 80 for an artificial tooth. Replacement of any of the natural teeth along the splinted area may be made at a later date by anchoring a plastic tooth using one of the threaded pins for a support.

While I have illustrated and described the presently preferred embodiment of my invention, it will be understood that various changes and modifications may be made therein, without however departing from the inventive concept thereof as set forth in the appended claims.

I claim:

1. The method of retaining a plurality of teeth by means of a dental retaining splint which comprises locating and forming facial-lingual apertures in the coronal portions of the teeth to be retained and forming an impression of the involved dental area, including the orientation of axes of said apertures, forming a cast model including said apertures from said impression -in an investment material, inserting a threaded pin through said apertures in said cast model, disposing a threaded nut on said threaded pin against the lingual surface of the cast of each of the involved teeth, said nut being disposed in axial alignment with its associated aperture, forming a wax-up of the desired splint along the lingual surfaces `of the cast of the involved teeth and casting out a metal splint body by the lost wax process, whereby said nuts are encased in said metal splint body, disposing said splint body against the facial surfaces of the involved teeth and securing said splint body in place by means of screw-threaded members inserted from the facial side of the apertures in said teeth.

2. The method according to claim 1, wherein said waxup includes the formation of a webspanning the area of a missing natural tooth, whereby the cast splint body will include a support for the replacement of a missing natural tooth,

3. The method of forming a dental retaining splint adaptable to be mounted in a mouth having teeth, each of said teeth having a facial surface and a lingual surface, said method comprising forming facial-lingual apertures in a plurality of said teeth which are to be retained, forming a wax-up of a splint having a surface configuration which corresponds to a plurality of said lingual surfaces and having a plurality of internally threaded recesses formed in the surface thereof each located inv a position with respect to the other which corresponds to the position in which the facial-lingual apertures are each located with respect to the other, and casting out a splint body from the wax-up.

4. The method according to claim 3, including the step of inserting a pin through each of the facial-lingual apertures after forming said apertures to locate the splint position for each of the internally threaded recesses.

References Cited UNITED STATES PATENTS 1,036,561 8/1912 Carter 22-190.1 2,362,741 11/1944 Berke l28-89.1 X 2,609,504 9/ 1952 Sprague 32-1 FOREIGN PATENTS 742,618 l/ 1933 France.

RICHARD A. GAUDET, Primary Examiner.

ROBERT E. MORGAN, Examiner, 

3. THE METHOD OF FORMING A DENTAL RETAINING SPLINT ADAPTABLE TO BE MOUNTED IN A MOUTH HAVING TEETH, EACH OF SAID TEETH HAVING A FACIAL SURFACE AND A LINGUAL SURFACE, SAID METHOD COMPRISING FORMING FACIAL-LINGUAL APERTURES IN A PLURALITY OF SAID TEETH, WHICH ARE TO BE RETAINED, FORMING A WAX-UP OF A SPLINT HAVING A SURFACE CONFIGURATION WHICH CORRESPONDS TO A PLURALITY OF SAID LINGUAL SURFACES AND HAVING A PLURALITY OF INTERNALLY THEREADED RECESSES FORMED IN THE SURFACE THEREOF EACH LOCATED IN A POSITION WITH RESPECT TO THE OTHER WHICH CORRESPONDS TO THE POSITION IN WHICH THE FACIAL-LINGUAL APERTURES ARE EACH LOCATED WITH RESPECT TO THE OTHER, AND CASTING OUT A SPLINT BODY FROM THE WAX-UP. 